Organ donation after euthanasia starting with anesthesia at home is legal in The Netherlands, Belgium, Canada and Spain.

We would like to respond to the article "Organ donation after euthanasia starting at home in a patient with multiple system atrophy Tajaâte et al., [2021] 22:120" on organ donation after euthanasia from home [ODEH]. Although we welcome the performance of ODEH, we would like to make some critical comments regarding the article, both in relation to factual inaccuracies and in terms of the vision expressed on this subject. In this letter we stress the protection of autonomy of vulnerable euthanasia patients, we contradict the assumption of illegality, we question if the anesthesia method utilized is optimal and correct a mistake in regard to an article to which is referred of ourselves.

Practice and challenges for organ donation after medical assistance in dying: A scoping review including the results of the first international roundtable in 2021.

The procedure combining medical assistance in dying (MAiD) with donations after circulatory determination of death (DCDD) is known as organ donation after euthanasia (ODE). The first international roundtable on ODE was held during the 2021 WONCA family medicine conference as part of a scoping review. It aimed to document practice and related issues to advise patients, professionals, and policymakers, aiding the development of responsible guidelines and helping to navigate the issues. This was achieved through literature searches and national and international stakeholder meetings. Up to 2021, ODE was performed 286 times in Canada, the Netherlands, Spain, and Belgium, including eight cases of ODE from home (ODEH). MAiD was provided 17,217 times (2020) in the eight countries where ODE is permitted. As of 2021, 837 patients (up to 14% of recipients of DCDD donors) had received organs from ODE. ODE raises some important ethical concerns involving patient autonomy, the link between the request for MAiD and the request to donate organs and the increased burden placed on seriously ill MAiD patients.

The hearing health of live-music sound engineers.

Most studies of hearing loss prevention in the music industry focus on the risk of hearing injury to musicians. However, live-music sound engineers (LMSE) may also be at risk of hearing injury due to their work-related sound exposure. We studied 27 LMSE, all of whom underwent otologic examination, including audiometry, distortion product otoacoustic emissions, speech discrimination and uncomfortable loudness levels, and completed a questionnaire investigating their history of sound exposure and use of hearing protectors. Hearing thresholds were significantly poorer than normative data across several frequencies, and a substantial proportion reported constant tinnitus (30%) and reduced sound tolerance (41%). Use of hearing protection was relatively low, with many reporting interference with their job when using it. Our results suggest that LMSE are at risk of hearing injury due to their work-related sound exposure.

Overview of laws and regulations aimed at protecting the hearing of patrons within entertainment venues.

BACKGROUND: Recreational noise-specifically loud music experienced at music venues-has been recognized as a hazard for hearing damage and associated pathologies such as tinnitus. In Europe and other countries around the world, there is a range of regulatory and legislative approaches to managing the sound levels and minimizing the risk of hearing damage for those attending music venues. It is important to have an understanding of these different approaches to inform the development of future regulations and legislation. METHODS: In December 2018, an online search of legislative instruments was conducted, and we identified 18 items that were aimed at protecting the hearing of people attending entertainment venues. RESULTS: Twelve documents were from European jurisdictions and the remainder were from cities or states of North and South America. The regulatory measures included in the documents ranged from sound level limitations, real-time sound exposure monitoring, mandatory supply of protective devices, requirements for signage and warnings, loudspeaker placement restrictions and the provision of 'quiet spaces'. CONCLUSIONS: European countries are well advanced in terms of providing legislation and other regulatory documents aimed at protecting people at entertainment venues when compared with the rest of the world. Future research is required to assess the effectiveness of these regulatory measures in reducing the risk associated with sound exposure at music venues.

Does person-centred care improve outcomes for musicians fitted with hearing protectors?

Objective: To reduce the risk of hearing injury, musicians are often recommended custom-made musicians' hearing protectors (MHP). Studies report benefits of use however, many still report challenges leading to relatively low uptake and inconsistent usage. Person-centred approaches to health have been shown to improve patient outcomes, and these principles may be translatable to musicians' hearing care. The aim was to investigate if use of, and satisfaction with, MHP is influenced by the treatment delivered to musicians by audiologists.Design: Participants were randomly allocated to one of four conditions that varied in extent of person-centred care.Study sample: Forty-two musicians with an interest in purchasing MHP were recruited.Results: Satisfaction with MHP was high overall and users reported a reduction in incidence of tinnitus. Participants reported few issues related to sound quality, however insertion difficulty was the main problem reported. Only one musician self-identified the need for alterations to their MHP.Conclusions: Adoption of person-centred approaches to MHP was not found to increase likelihood of use, however, satisfaction was high across all conditions. Most often, the need for MHP alterations were clinician-identified during fitting appointments or follow-up contact, underscoring the importance of including these components when providing audiological services to musicians.

Applying the Hierarchy of Hazard Control to Regulation of Sound Levels in Entertainment Venues.

Excessive sound levels at events where amplified music is a central element pose a risk to hearing. Whereas noise exposure in the workplace has been recognized as a hazard for over a century, the potential harm resulting from recreational sound exposure has only become apparent in recent years. In occupational settings where sound levels are high, employers are required to implement risk-mitigation strategies to reduce sound exposure and protect employees in accordance with the hierarchy of controls. In principle, this same risk management approach can be applied to entertainment venues. In this paper we discuss how the measures stipulated in various policies and regulations aimed at protecting the hearing of audience members at entertainment venues fit within the hierarchy of controls. We compare the relative likely effectiveness of each of the measures and outline how the particular characteristics of entertainment venues impact on the practical application of these measures.

Caring for musicians' ears: insights from audiologists and manufacturers reveal need for evidence-based guidelines.

OBJECTIVE: This study investigated clinical care delivered to musicians in Australia by audiologists and manufacturers of musicians' hearing protectors (MHP). DESIGN: Audiologists with experience treating musicians were invited to complete a survey on their service delivery. A second survey was administered to manufacturers of MHPs. STUDY SAMPLE: Four manufacturers of MHP and 31 audiologists completed the surveys. Post hoc analyses were performed comparing the responses of audiologists with more versus less clinical experience; and those with and without musical training. RESULTS: There was considerable variation in the audiological care provided to musicians. Only one-third of audiologists performed pure-tone audiometry prior to MHP fitting, and there was little consistency across the sample in relation to impression taking, preferred attenuation or selection of canal length. There was also significant variation in the manufacturers' approach to MHP, each of whom provided different recommendations regarding preferred impression techniques and material viscosity. CONCLUSIONS: The results of this study reveal lack of consistency across the hearing healthcare sector with respect to care of musicians' hearing, with potential to impact upon the satisfaction with, and usage of, MHP. There is need for evidence-based, best practice guidelines and training to support clinical audiologists in providing optimal care.